Many experts think it makes sense to get tested at menopause, or even earlier so you have a baseline score to compare later scans. The peripheral heel or wrist scan has been shown to be an accurate initial screening tool; if you get a low score, you should follow up with a DXA scan. "My personal opinion is that all women at menopause should be tested," says Felicia Cosman, M.D., clinical director of the National Osteoporosis Foundation. "But we can't recommend that officially, because it would cost too much." So for now, the foundation advises that women first get tested at menopause only if they have certain risk factors, including: a small frame or weight of less than 127 pounds, a family history of osteoporosis, a personal history of fracture after age 50 or a smoking habit. Otherwise, you're counseled to wait until you turn 65. After that, new guidelines from the U.S. Preventive Services Task Force recommend screenings at least every two years.
Whenever you do get tested, try not to panic about the results. It's normal to be worried about your bones if your mother has osteoporosis or if you are a slender white woman who hates milk and loves pinot noir. And it's right to want to take charge of your health. "But the thing to remember," says Siris, "is that if you have osteopenia, it doesn't mean your bones are going to fall apart overnight. And there's a lot you can do to keep them strong right now."